Physiological Changes of Pregnancy Flashcards

Question

Uterus

Answer 1

The uterus grows in size to accommodate the growing fetus Weight of the uterus grows from 60 grams (0.13lbs) to 1100 grams (2.4lbs) The capacity of the uterus grows from holding about 10 ml to about 1500 ml

Answer 2

Before pregnancy: > Uterus measures 7.5 x 5 x 2.5 cm At the end of the pregnancy: > Uterus measures 28 x 23 x 21 cm

Answer 3

12 weeks - 14 weeks of gestation: Palpated right above the symphysis pubis Size of a grapefruit 20 - 24 weeks gestation: The uterus is about the level of the umbilicus 36 weeks gestation Touches xiphoid process

Answer 4

38–40 weeks gestation (approximately) >Lightening >>Height drops as the fetus settles into the pelvis >>Usually felt about two weeks before the term for primigravida pts >>May not occur until the morning of the birth for multiparas.

Answer 5

Increases during pregnancy to meet the requirement of the placenta Before pregnancy: Uterine blood flow is the rate of 15–20 ml/min End of pregnancy: 500–750 ml/min

Answer 6

It occurs during the first trimester Softening of the isthmus of the uterus Area between the cervix and the body of the uterus Feels as thin as tissue paper The bimanual exam will reveal Hegar's sign *Softening of the lower uterine segment

Answer 7

Uterine contractions Start after the fourth month of pregnancy. Present throughout the pregnancy, become harder as the pregnancy advances >>After the 28th week, they get much harder The monitor would pick them up, but the mom may not notice them

Answer 8

> May be confused with real labor due to the discomfort > Do not cause cervical changes >Do not increase in intensity or frequency

Answer 9

>Increased levels of Estrogen: >>Stimulates the glandular tissue of the cervix to secrete a thick mucus >>This thick mucus accumulates and forms the ____________ (mucus plug) >Mucus plug is expelled when cervical dilation begins >>Cervix forms protective _________ for fetus barrier for fetus

Answer 10

>Softening of the cervix >Noticeable during the first 3 months >>Caused by an increased level of estrogen >>This leads the cervix to be more vascular and edematous

Answer 11

>Violet or bluish discoloration of the vaginal mucous membrane and cervix >Noticeable during the first 3 months >Due to the increased vascularity

Answer 12

> Passive movement of the unengaged fetus > Can be identified between the 16th and 18th week > The technique of palpating a floating structure by bouncing it gently and feeling it rebound > Place a finger in the vagina and tap gently upward, causing the fetus to rise. > The examiner will feel the fetus rise, then rebound back.

Answer 13

> Increase in estrogen causes: >> A thickening of the wall of the vaginal mucosa >> Connective tissue to loosen >> Increase in vaginal secretions ____________ >>>White mucus discharge with a faint, musty odor >>Not pruritic >>Not blood stained

Answer 14

> The pH of the vagina becomes more acidic > This Acidic pH helps to prevent bacterial infection but favors yeast > Increase in blood perfusion to the vagina Chadwick's sign is present in the vagina and the cervix

Answer 15

> Increase in Estrogen and Progesterone: >> Cause changes in the mammary glands Breasts enlarge >> One of the _____ symptoms of pregnancy (about 6 weeks) > Glands increase in size and number > Superficial veins become more prominent

Answer 16

> Nipples become more erectile > Areolas darken > Montgomery’s follicles enlarge >>Sebaceous glands >Striae may develop >>Stretch marks

Answer 17

Colostrum is present during the second and third trimester Possibly as early as the 16th week Antibody-rich yellow secretion Gradually converts to mature milk during the first few days after childbirth.

Answer 18

The volume of air breathed/min. Increases 30% - 40% in pregnancy. To meet increased oxygen requirements Progesterone decreases airway resistance-- Permits 20-40% increase in oxygen consumption _______ stuffiness or congestion

Answer 19

As the uterus enlarges, it presses upward and elevates the diaphragm. The anterior-posterior diameter of the rib cage expands by as much as 6 cm. No significant loss of intrathoracic volume Breathing changes from abdominal to thoracic.

Answer 20

> Enlarged uterus presses upward & elevates diaphragm--SOB > Anterior-posterior diameter of the rib cage expands up to 6 cm > No significant loss of intrathoracic volume >Breathing changes from abdominal to thoracic >When ___________ occurs, the difficulty breathing will get better!

Answer 21

> During the period when the corpus luteum is so active, the temperature will rise slightly > As the placenta takes over the function of hormone production, the temp will return to normal > This rise in temp will occur along the same time as the ______ __________!

Answer 22

> Blood Volume >>Progressively increases beginning in the 1st trimester >>>To provide nourishment for the placenta and to compensate for blood loss during delivery > Increases rapidly in 2nd trimester >> Blood volume will increase by 40–50% during pregnancy > Peaks in the third trimester, about 32 weeks Bleeding Gums are common

Answer 23

> Red Blood Cell mass will increase by 20-30% >> Needed to carry additional oxygen > Plasma volume increases by about 50% > Physiologic ________ of Pregnancy: >>Plasma increases more than erythrocytes >>Thus, the H & H will decrease by 7% when looking at the serum level >>>Due to hemodilution

Answer 24

Needed by most women Usually, they don’t have enough iron stored for reserve. The fetus requires 350–400 mg of iron. An increase in circulating red blood cells needs additional iron. Prevent anemia with early dx & early tx through prenatal visits.

Answer 25

> Increases by 30 – 50% Heart rate > Increases by 10 to 15 beats per minute >The woman with a normal good heart will be able to handle this increased workload of the heart, but a woman with a weak heart will have an _________ in cardiac problems

Answer 26

Benign > Due to the diaphragm pushing upwards and the increase in blood volume > As the diaphragm pushes upward, it will shift the heart’s position

Answer 27

> Leukocyte production increases slightly during pregnancy 5,000–15,000/mm > During labor and early postpartum 25, 000 or higher

Answer 28

Blood flow to the lower extremities is often impaired by the pressure of the expanding uterus on veins and arteries This leads to edema and varicose veins of the vulva, rectum and legs

Answer 29

Despite the increase in blood volume, the BP does not usually _________ Slight ___________ in second trimester Return to pre-pregnancy level by the third trimester The increased heart rate compensates for the blood volume increase.

Answer 30

> An enlarged uterus may press on the vena cava and the aorta. > Reduces blood flow to the right atrium ___________ blood pressure, causes dizziness… > Will also reduce blood flow to the ___________ > Avoid laying supine!

Answer 31

> Nausea and Vomiting > Common during the first trimester > Due to rising HCG levels and lowering Blood Glucose levels > Typically occurs from 4 weeks – 12 weeks > Delayed Gastric Emptying Time and peristalsis > Due to smooth muscle relaxation from elevated _____________ levels > Results in bloating and _____________

Answer 32

Gums > Hyperemic > Tend to bleed easily Heartburn and flatulence > Caused by the uterus growing and displacing the stomach and the intestines > The Cardiac Sphincter also relaxes, which contributes to heartburn Delayed gastric emptying and decreased peristalsis > Caused by increased progesterone production, which decreases the tone and motility of smooth muscles.

Answer 33

Increases during pregnancy Changes in metabolism are due to the increased demand of the growing fetus Returns to pre-pregnancy levels about 5 – 6 days after delivery

Answer 34

Recommended weight gain for women of normal pre-pregnancy weight is _________pounds For women who were overweight, the recommended weight gain is __________ pounds. For underweight women, they are advised to gain the weight needed to reach their ideal weight, plus __________ pounds

Answer 35

During 1st & 3rd trimester, _______ is pressing into pelvic organs During 2nd trimester, the uterus is growing into the abdominal area

Answer 36

Increases about 60 – 80% because the kidneys are excreting waste from the woman and the fetus Glucosuria Trace amounts of glucose may spill into the urine due to the kidneys inability to filtrate all of the glucose. More than ____________ is abnormal

Answer 37

> Larger amount of urine is held in the kidneys and ureters. > Urine flow rate is decreased, leading to urinary stasis >Bladder capacity increases to 1500ml because bladder tone decreases. >All of these changes lead to an increase risk of UTI and Pyelonephritis

Answer 38

AKA Stretch marks > Abdomen, thighs, buttocks and breasts > Pink or red color during pregnancy > Will turn a silvery color after delivery

Answer 39

Also called the “mask of pregnancy.” Darkening of skin over the forehead and around the eyes Will subside after childbirth

Answer 40

Changes in skin pigmentation is common Overactive sweat glands also common Due to increased estrogen, progesterone and melanotropin

Answer 41

Calcium and Phosphorus needs are increased to allow the fetal skeleton to form. Pelvic ligaments and joints gradually soften during pregnancy to allow for extension. Causes a waddling gait

Answer 42

Lumbar spine curves to compensate for the increased weight of the uterus anteriorly Results in low backaches

Answer 43

Rectus Abdominis muscles of the abdominal wall stretch and lose some tone Muscles may separate during 3rd trimester After birth, the muscles gradually regain some tone.

Answer 44

> Placenta > Considered an endocrine organ > Formed during pregnancy > It is classified an endocrine organ because it creates hormones >>Estrogen and Progesterone >> Human Chorionic gonadotropin >> Human chorionic somatomammotropin

Answer 45

Enlarges slightly due to increased vascularity The level of T4 increases beginning at 6-9 weeks. Plateaus at 18 weeks Metabolic rate increases by as much as 25% during pregnancy Thyroid function will return to normal immediately after birth

Answer 46

Anterior Pituitary Decreased production of FSH & LH Increased production of Prolactin & Growth Hormone Posterior Pituitary Increased production of oxytocin throughout the pregnancy Stimulates uterine contractions and stimulates ejection of milk letdown reflex

Answer 47

Increase release of Cortisol Cortisol levels return to normal 1 – 6 weeks post partum Increase in aldosterone Results in an increase in reabsorption of potassium

Answer 48

Categorized as: >Presumptive - Changes felt by the woman >Probable - Changes observed by an examiner > Positive - Those that can be attributed only to the presence of a fetus

Answer 49

Breast Changes Amenorrhea Nausea and vomiting Excessive fatigue Urinary Frequency Nasal Stuffiness Mood swings Quickening - Occurs about 16-20 weeks

Answer 50

Do not confirm pregnancy 1. Changes in pelvic organs Goodell’s sign Chadwick’s sign 2. ________________________ Detects HCG in the urine/serum

Answer 51

General enlargement of the uterus after 8 weeks of pregnancy Ballottement Via vaginal exam Braxton Hicks Contractions Palpated after the 28th week Skin pigment changes Areola, linea nigra, facial melasma…

Answer 52

Cannot be confused with any other pathological state Conclusive proof of pregnancy _______ ______________ Heard with Doppler at about 14-16 weeks As early as 6 weeks via U/S

Answer 53

Fetal movement Palpated by a ______ _____________after about the 20th week Visualization of the fetus Via ____________________ As early as 5 - 6 weeks to detect fetal parts

Physiological Changes of Pregnancy Flashcards

(77 cards)